Once completed, you will receive a confirmation email to acknowledge receipt of your submission. In addition to this completed application, you must send the following to firstname.lastname@example.org:
- Signed confirmation that you have read and agree to our liability, confidentiality/HIPAA, and behavior policies.
- A copy of your health insurance card.
- Proof of required immunizations/tests, including MMR, TB test, flu (during certain times of year) and COVID-19.
- Signed Release and Waiver of Liability form. Please note there are separate forms for minors (under 18 years old) and adults.
This and any other requested documentation will need to be submitted to email@example.com.
NOTE: Completion of the application does NOT guarantee that you will be able to shadow. Departments will make accommodations as patient schedules and staffing permits. Please allow one to two weeks for a response.